Feeding and Growth Outcomes in Infants with Type C Esophageal Atresia Who Undergo Early Primary Repair.

Abstract

OBJECTIVES\nDescribe growth and feeding outcomes in patients with type C esophageal atresia, who underwent early primary repair, and to identify predictors for poor growth.\n\n\nSTUDY DESIGN\nSingle-center, retrospective, cohort study of all patients with type C esophageal atresia, who underwent early primary repair, from 2013 to 2019. Weight-for-age z score (WAZ) was calculated at birth, and every 6 months until 3 years post-operatively. Longitudinal median regression was used to evaluate WAZ over time. A multivariable logistic regression model explored predictors of growth outcomes.\n\n\nRESULTS\nOf 46 infants that met inclusion criteria, 72% were term. The median age at repair was 1.5 (IQR 1, 2) days of life and the hospital length of stay was 20 (IQR 14, 30) days. Two patients had esophageal leak (4.3%). Median WAZ at birth was below average (-0.72 [IQR -1.37, -0.40]), but improved to reach average by 3 years (-0.025 [IQR -0.85, 0.97], P < .001). At discharge, 72% of patients were receiving full oral nutrition, which improved to 95% by 3 years. The only independent predictor of poor growth at 1 year (WAZ < -1; 33%) was WAZ at discharge (p=0.02).\n\n\nCONCLUSIONS\nInfants with esophageal atresia who undergo early primary repair are capable of achieving standard growth curves by 3 years of age. However, poor discharge WAZ score was predictive of poor WAZ score at one year. Efforts to identify at-risk patients and institute targeted inpatient and outpatient nutrition interventions are needed to improve their growth trajectory.